Physical, Biochemical, and Neuromuscular Responses to Repeated Sprint Exercise in Eumenorrheic Female Handball Players: Effect of Menstrual Cycle Phases

Abstract

Graja, A, Kacem, M, Hammouda, O, Borji, R, Bouzid, MA, Souissi, N, and Rebai, H. Physical, biochemical, and neuromuscular responses to repeated sprint exercise in eumenorrheic female handball players: effect of menstrual cycle phases. J Strength Cond Res 36(8): 2268–2276, 2022—Very few studies have been interested in the relationship between ovarian hormones and physiological function in female athletes. The aim of this study was to assess the effect of menstrual phases (MP) on physical, neuromuscular, and biochemical responses after repeated sprint exercise (RSE) in female handball players. Ten eumenorrheic athletes (22.5 ± 1.5 years, 1.70 ± 0.04 m) participated in 3 study visits (follicular phase [FP], luteal phase [LP], and premenstrual phase [PMP]). During each MP, they performed 20 × 5-second cycle sprints interspersed with 25 seconds of rest. Maximal voluntary contraction (MVC) tests of the knee extensor muscles at 90° of knee flexion were performed before and after RSE. Peak force and electromyography (EMG) signals were measured during the MVC tests. Blood samples were collected before and 3 minutes after each session. The percentage of decrement in peak power output over the 20 × 5-second cycle test (i.e., fatigue index) calculated between sprints 1 and 20 decreased significantly during PMP (−43.3% ± 5.7%) but not in LP (−39.2% ± 7.7%) compared with FP (−32.44% ± 6.3%) (p < 0.05). Moreover, no significant difference was found between MP in all frequency components of EMG before RSE (p > 0.05). Maximal voluntary contraction, neuromuscular efficiency, and median frequency values of vastus lateralis and rectus femoris were significantly decreased in PMP compared with FP and LP (p < 0.05). Creatine kinase (CK) levels were significantly higher in PMP compared with FP and LP after RSE (p < 0.05). These findings suggest that RSE induces more peripheral fatigue associated with muscle damage in PMP. This might be attributable to hormonal variation across MP. Therefore, FP seems to be the right time for intense training to improve strength performance.

The Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review

“…Compared to anaerobic and aerobic performance, muscular strength seems more likely to be affected by MC phase. Muscular strength, determined by tests measuring maximal voluntary contractions and force production, was reported in five studies as being affected by MC phase [ 21 , 68 , 91 , 101 , 103 ], whilst five studies reported no MC phase effects on strength [ 52 , 71 , 94 , 95 , 99 ] and one study reported a change in some strength outcomes and no change in other strength outcomes [ 89 ].…”

“…However, multiple studies presented results that contradict this mechanism. Multiple studies found that there was no difference in strength between the late follicular and mid luteal phases [ 21 , 91 , 94 , 99 ], and strength outcomes were lower in the early follicular phase compared to the mid and late luteal phases [ 21 ], increased in the luteal phase [ 89 ], and significantly [ 103 ] and non-significantly [ 99 ] increased in the ovulatory phase.…”

“…Six studies [ 53 , 88 , 91 , 92 , 104 , 109 ] demonstrated MC phase differences in aerobic exercise performance or applied physiological outcomes related to aerobic performance; two studies found some outcomes were affected by MC phase while others were unaffected [ 52 , 90 ], and the majority of studies ( n = 14) concluded MC phase had no affect [ 46 , 52 , 54 , 86 , 87 , 93 , 96 , 97 , 98 , 105 , 107 , 108 , 110 , 111 ]. Continuous endurance performance measured with time to exhaustion tests [ 52 , 87 , 90 ], power output during maximal treadmill [ 86 ] and cycle [ 97 , 105 ] and rowing [ 111 ] tests and a 2000 m rowing time trial [ 93 ] was not affected by MC phase.…”

“…Performance in some intermittent endurance tests may have been greater in the follicular phases [ 53 , 91 ] due to the absence of increased thermoregulatory and cardiovascular strain during the luteal phase [ 39 , 40 , 41 ]. The finding that more runners produced their best marathon times during the luteal phase than the follicular phase [ 92 ] contradicts the hypothesis that increased strain during the luteal phase impairs performance, but this study did not consider confounders such as environmental conditions and the terrain or course undertaken, which may have impacted performance, and it only considered the best time recorded and it separated the MC using a simple two-phase model [ 92 ].…”

“…Intermittent endurance performance appeared more likely to be influenced by MC phase than continuous endurance performance. Two studies concluded that athletes' performance intermittent exercise tests were unaffected by MC phase [98,108,110], but improvements in the follicular phase have been observed; specifically, distance covered in a Yo-Yo Intermittent Endurance test increased in the early follicular phase [53], and during late follicular phase, fatiguability was reduced based on the lower fatigue index and the higher peak power in the final intervals of a repeated cycle sprint test [91]. Inconsistent with these results was the finding that repeated long duration sprint times were decreased in the late follicular, and early and mid luteal phases compared to the ovulatory and late luteal phases [104].…”